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Based on public Medicaid payment data.

Average Medicaid Prescription Medications Payments

Typical Medicaid Prescription Medications reimbursement across 5,304 cities

Avg. Medicaid Paid

$28.35

Price Range

$0.00 – $2,704

Total Claims

61.1M

Cities

5304

Typical Payment Range

Typical Medicaid Prescription Medications payments fall between $0.68 and $14.54 per claim (median: $2.87). The top 10% of payments exceed $78.92.

Based on per-provider averages across all Medicaid claims in this category.

About This Procedure

Prescription drug costs and pharmacy services covered under Medicaid. Includes brand-name and generic medications across all therapeutic categories.

Why do these costs look low?

These figures represent Medicaid reimbursement rates β€” the amounts that state Medicaid programs actually paid providers. Medicaid typically reimburses significantly less than private insurance or out-of-pocket prices. If you have private insurance or are paying cash, expect higher costs. See the cost components below for per-code averages.

Costs by City

City Avg. Paid Min / Max Claims Providers
Mora, MN $6.61 $0.46 – $7.98 71 2
Dublin, VA $12.68 $12.68 – $12.68 71 1
Lakeview, OH $0.05 $0.05 – $0.05 71 1
New London, NH $427.03 $427.03 – $427.03 72 1
Providence, KY $1.00 $1.00 – $1.00 72 1
Bordentown, NJ $9.81 $9.81 – $9.81 72 1
Peterstown, WV $0.06 $0.00 – $0.29 72 2
Westwood, MA $3.60 $2.87 – $5.53 73 2
Warwick, NY $1.61 $1.61 – $1.61 73 1
Wood Dale, IL $35.48 $35.48 – $35.48 73 1
Swifton, AR $0.00 $0.00 – $0.00 73 1
Corfu, NY $11.90 $11.90 – $11.90 73 1
New Hudson, MI $0.71 $0.71 – $0.71 73 1
Rockledge, FL $0.23 $0.09 – $0.39 74 2
Detroit Lakes, MN $0.67 $0.61 – $0.71 74 2
Flower Mound, TX $12.05 $0.56 – $19.46 74 2
Roseville, MN $4.59 $0.47 – $9.43 74 2
Petal, MS $3.90 $0.55 – $4.97 74 2
Walker, LA $0.11 $0.11 – $0.11 74 1
Altoona, AL $12.76 $12.76 – $12.76 74 1
Center Point, IA $0.36 $0.36 – $0.36 74 1
Highland, MI $0.89 $0.89 – $0.89 74 1
W. St. Paul, MN $0.01 $0.00 – $0.01 74 2
Crewe, VA $3.01 $3.01 – $3.01 74 1
Coffeeville, MS $2.74 $2.74 – $2.74 74 1
Carbon Hill, AL $2.47 $2.47 – $2.47 74 1
Brevard, NC $42.53 $4.09 – $52.95 75 2
Oak Harbor, WA $4.75 $4.21 – $4.87 75 2
Brighton, MA $5.30 $3.32 – $7.69 75 2
Talbott, TN $1.28 $1.28 – $1.28 75 1
Dorado, PR $1.07 $1.07 – $1.07 75 1
Piscataway, NJ $6.49 $6.49 – $6.49 75 1
Crawfordville, FL $2.29 $2.29 – $2.29 75 1
Richland, GA $26.99 $15.97 – $71.06 75 2
Shrevport, LA $7.19 $7.19 – $7.19 75 1
Fulton, NY $7.35 $0.18 – $11.07 76 3
Lake Worth, FL $2.17 $0.94 – $2.84 76 2
Deer Lodge, MT $0.44 $0.44 – $0.44 76 1
Royston, GA $4.34 $0.28 – $5.25 76 2
Accomac, VA $8.70 $8.70 – $8.70 76 1
Glen Daniel, WV $14.36 $0.86 – $32.91 76 2
Fort Lee, NJ $0.71 $0.16 – $2.66 77 2
Grandview, WA $1.63 $1.63 – $1.63 77 1
Brooklyn Park, MN $36.65 $8.85 – $85.30 77 2
Highland Park, IL $30.12 $2.18 – $65.46 77 2
Winsted, CT $1.03 $0.86 – $1.08 77 2
West Point, IA $77.90 $77.90 – $77.90 77 1
Godfrey, IL $1.01 $1.01 – $1.01 77 1
Mountain Home, TN $14.86 $10.64 – $18.57 77 2
Gaston, SC $0.24 $0.24 – $0.24 77 1

Cost Components

National averages for each billing code in this procedure category. Sorted by claim volume.

Code Description Avg. Paid Claims Providers
J1100 Dexamethasone sodium phos $3.37 17,408,335 19,920
J1270 Injection, doxercalciferol $16.67 15,455,545 1,785
J0696 Ceftriaxone sodium injection $4.52 8,442,343 9,869
J1170 Hydromorphone injection $3.20 6,069,586 3,002
J1200 Diphenhydramine hcl injectio $3.10 5,922,771 3,790
J0690 Cefazolin sodium injection $5.07 4,950,109 2,942
J1050 Medroxyprogesterone acetate $38.04 2,722,661 5,740
J0131 Inj, acetaminophen (nos) $15.79 2,017,135 1,612
J1030 Methylprednisolone 40 mg inj $5.08 1,577,497 4,461
J0882 Darbepoetin alfa, esrd use $63.10 1,115,197 646
J1040 Methylprednisolone 80 mg inj $6.39 1,102,119 2,895
J0585 Injection,onabotulinumtoxina $534.00 949,108 1,450
J0702 Betamethasone acet&sod phosp $9.01 907,372 2,580
J0780 Prochlorperazine injection $4.11 869,130 1,089
J0178 Aflibercept injection $802.42 747,781 1,182
J0171 Adrenalin epinephrine inject $5.61 533,091 956
J0897 Denosumab injection $708.53 175,698 394
J1071 Inj testosterone cypionate $3.01 121,666 206
J0636 Inj calcitriol per 0.1 mcg $2.19 94,974 28
J0885 Epoetin alfa, non-esrd $82.64 88,458 179
J1020 Methylprednisolone 20 mg inj $3.48 88,065 344
J0881 Darbepoetin alfa, non-esrd $149.52 63,199 108
J0878 Daptomycin injection $167.80 55,762 36
J1245 Dipyridamole injection $5.21 54,912 138
J0592 Buprenorphine hydrochloride $15.56 48,440 32
J0153 Adenosine inj 1mg $18.75 46,321 143
J0670 Inj mepivacaine hcl/10 ml $0.91 37,668 90
J0129 Abatacept injection $1,614 34,397 89
J0735 Clonidine hydrochloride $6.85 32,191 92
J0610 Calcium glucon (fresenius) $9.34 31,253 88
J0135 Adalimumab injection $738.85 28,382 35
J1094 Inj dexamethasone acetate $2.39 27,586 144
J0717 Certolizumab pegol inj 1mg $2,072 22,279 41
J0697 Sterile cefuroxime injection $0.94 18,132 47
J0256 Alpha 1 proteinase inhibitor $2,389 16,156 1
J1250 Inj dobutamine hcl/250 mg $6.92 14,579 60
J0588 Incobotulinumtoxin a $295.98 10,950 18
J1325 Epoprostenol injection $636.33 9,713 5
J1240 Dimenhydrinate injection $0.02 8,738 12
J1000 Depo-estradiol cypionate inj $11.84 1,738 11
J1230 Methadone injection $4.00 1,439 2
J1212 Dimethyl sulfoxide 50% 50 ml $175.32 1,145 5
J1265 Dopamine injection $2.67 840 1
J0132 Acetylcysteine injection $0.11 814 6
J0834 Inj., cosyntropin, 0.25 mg $60.82 696 6
J1120 Acetazolamid sodium injectio $8.30 446 4
J0713 Inj ceftazidime per 500 mg $8.01 398 5
J0698 Cefotaxime sodium injection $0.61 371 9
J0775 Collagenase, clost hist inj $9,463 323 1
J0207 Amifostine $23.74 42 β€”
J0120 Tetracyclin injection β€” β€” β€”
J0133 Acyclovir injection β€” β€” β€”
J0202 Injection, alemtuzumab β€” β€” β€”
J0795 Corticorelin ovine triflutal β€” β€” β€”
J1160 Digoxin injection β€” β€” β€”
J1205 Chlorothiazide sodium inj β€” β€” β€”
J1260 Dolasetron mesylate β€” β€” β€”
J1290 Ecallantide injection β€” β€” β€”
J1300 Eculizumab injection β€” β€” β€”
J1301 Injection, edaravone, 1 mg β€” β€” β€”
J1303 Inj., ravulizumab-cwvz 10 mg β€” β€” β€”
J1305 Inj, evinacumab-dgnb, 5mg β€” β€” β€”
J1320 Amitriptyline injection β€” β€” β€”
J1322 Elosulfase alfa, injection β€” β€” β€”
J1327 Eptifibatide injection β€” β€” β€”

These averages group common billing codes used when providers bill Medicaid for this procedure. Individual costs will vary.